国产安非他酮与帕罗西汀治疗老年抑郁症对照研究

A control study of domestic bupropion versus paroxetine in the treatment of senile depession

目的探讨国产安非他酮与帕罗西汀治疗老年抑郁症的临床疗效及安全性。方法将80例老年抑郁症患者随机分为两组各40例，研究组口服安非他酮治疗，对照组日服帕罗西汀治疗，观察6w。于治疗前及治疗1w、2w、4w、6w末采用汉密顿抑郁量表、汉密顿焦虑量表评定临床疗效，副反应量表评定不良反应。结果治疗6w末，研究组显效率为80．0％，对照组为75．0％，两组无显著性差异（χ^2=0．287，P〉0．05）。汉密顿抑郁量表评分，研究组治疗1w末起，对照组治疗2w末起较治疗前有显著下降（P〈0．01），研究组治疗1w末较对照组下降显著（P〈0．05）。汉密顿焦虑量表评分，研究组治疗2w末起，对照组治疗1w末起较治疗前有显著下降（P〈0．05或0．01）；对照组治疗后各时点均较研究组下降显著（P〈0．05）。两组总体不良反应发生率无显著性差异（P〉0．05），但研究组头痛、嗜睡、体重增加发生率显著低于对照组（P〈0．05）。结论国产安非他酮与帕罗西汀治疗老年抑郁症疗效均显著，但安非他酮抗抑郁起效更快，不良反应较轻，而抗焦虑作用不如帕罗西汀。

Objective To compare efficacy and safety between domestic bupropion and paroxetine in the treatment of senile depression. Methods 80 senile depression patients were randomly assigned to two groups of 40 ones each,research group took orally bupropion and control group did paroxetine for 6 weeks. Before treatment and at the end of the the 1st, 2nd, 4th and 6th week, clinical efficacies were assessed with the Hanmilton Depression Scale（HAMD） and the Hanmilton Anxiety Scale（HAMA） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） . Results At the end of the 6th week, obvious effective rates were respectively 80.0% in the research and 75.0% in the control group, which showed no significant difference（P〉0.05）. The HAMD scores lowered more significantly singce the end of the 1st week in the research and the 2nd in the control group compared with pretreatment（P〈0.01） ; at the end of the 1st week, those did more significantly in the research than in the control group（P〈0.05）. The HAMA scores lowered more significantly singce the end of the 2nd week in the research and the 1st in the control group compared with pretreatment（P〈0.05 or 0.01） ; after treatment, each timepoint score lowered more significantly in the control than in the research group（P〈0.05）. There were no significant differences of adverse reactions between the 2 groups（P〉0.05） ,but the incidence of headache, drowsiness and weight gain was significantly lower in the research than in the control group（P〈0.05）. ConcLusion Both domestic bupropion and paroxetine are effective on senile depression;but the former takes effect faster,has mild adverse reactions,its antianxiety effect is inferior to the latter.